If you guessed “C” you’d be correct!

This study published January 4th, 2019 revealed that when it comes to lumbar spinal stenosis “manual therapy/individualized exercise had a greater improvement of symptoms and physical function (at 2 month follow-up) compared with medical care or group exercise.”

What is lumbar spinal stenosis (LSS)?

Lumbar spinal stenosis is a common degenerative spinal condition characterized by a significant limitation in walking, heightened risk of falls, and disability. Patients with this condition may also experience symptoms such as:

  • Symptoms in the legs which are worse with walking and relieved with rest
  • Symptoms that worsen with low back extension but is improved with forward bending
  • Relief is experienced when leaning forward on a shopping cart when walking.

Surgical fusion is a widely used intervention for LSS because little was previously known about the effects of nonsurgical treatments for this condition. Several studies such as this one aim to close the evidence gap and determine whether or not these nonsurgical interventions could help in the management of spinal stenosis.

Some important details:

This randomized clinical trial looked at the efficacy of three different, non-surgical interventions for lumbar spinal stenosis. 259 underwent three possible treatments (listed as A, B, or C above). Most of the responders came from the manual therapy/exercise group after 2 months, however it’s worth mentioning that there we no between-group differences at the 6 month follow-up. Bottom line: patients can show improvements in their capacity to walk through non-surgical interventions.


Schneider MJ, Ammendolia C, Murphy DR, et al. Comparative Clinical Effectiveness of Nonsurgical Treatment Methods in Patients With Lumbar Spinal Stenosis: A Randomized Clinical Trial. JAMA Netw Open.2019;2(1):e186828. doi:10.1001/jamanetworkopen.2018.6828